Fri Oct 28 2022

42 articles - From Friday Oct 21 2022 to Friday Oct 28 2022

parm_toc.knit

Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Kidney Int

Executive summary of the KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease: an update based on rapidly emerging new evidence.

Treatment approaches and guideline recommendations are based on systematic reviews of relevant studies and appraisal of the quality of the evidence, and the strength of recommendations followed the "Grading of Recommendations Assessment, Development and Evaluation" (GRADE) approach. Limitations of the evidence are discussed, and areas for which additional research is needed are presented.

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KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease.

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Nephrol Dial Transplant

Clinical implications and guidelines for CKD in type 2 diabetes.

Current guidelines continue to recommend screening for CKD, blood pressure control using RAS inhibition as first line therapy, and glucose control. SGLT2 inhibition and finerenone are recent additions to current guidelines to improve CKD outcomes in T2D, based on robust clinical trial data.

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Overcoming barriers to implementing new guideline-directed therapies for chronic kidney disease.

These barriers to optimal cardiorenal outcomes can be ameliorated by a multifaceted approach, using the Chronic Care Model framework, to include patient and provider education, patient self-management programs, shared decision making, electronic clinical decision support tools, quality improvement initiatives, clear practice guidelines, multidisciplinary and collaborative care, provider accountability, and robust health information technology. It is incumbent on the global kidney community to take on a multidimensional perspective of CKD care by addressing patient, community, provider, healthcare system, and policy-level barriers.

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Meta-analysis

meta-analyses and systematic reviews


Original articles

RCT, clinical trials, retrospective studies, etc…

Am J Kidney Dis

Obstacles and Opportunities in Managing Coexisting Obesity and CKD: Report of a Scientific Workshop Cosponsored by the National Kidney Foundation and The Obesity Society.

The group identified strategies to increase patient and provider engagement in obesity management, outlined a collaborative action plan to engage nephrologists and obesity medicine experts in obesity management, and identified research opportunities to address gaps in knowledge about the interaction between obesity and kidney disease. The workshop's conclusions help lay the groundwork for development of an effective, scientifically based, and multidisciplinary approach to the management of obesity in people with CKD.

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Clin J Am Soc Nephrol

A Qualitative Content Analysis of Comments on Press Articles on Deemed Consent for Organ Donation in Canada.

Improving government transparency and communication, clarifying questions and addressing concerns, and providing evidence for the bills were identified as key considerations. If deemed consent legislation is meant to increase organ donation and transplantation, addressing public concerns will be important to ensure successful implementation.

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How the Routine Use of Patient-Reported Outcome Measures for Hemodialysis Care Influences Patient-Clinician Communication: A Mixed-Methods Study.

While patient-reported outcome measures use did not improve patient-clinician communication, qualitative data suggest implementation challenges, including limited clarity of purpose and perceived limited value, that may have limited the effectiveness of the intervention.

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Nephrology Program Director Protected Time for Program Administration in the United States.

Approximately half of nephrology programs surveyed were not in compliance with the ACGME-stipulated 10 hour/week minimum protected time for the 2021-22 training year. Program directors estimated a median 12 hours/week are needed to effectively manage programs.

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Toxic Occupational Exposures and Membranous Nephropathy.

Patients with membranous nephropathy were more frequently exposed to certain occupational toxic substances, such as asbestos and organic solvents, than the general population. This occupational exposure was more frequent in men and in patients with PLA2R1 epitope spreading. Clinical trial registry name and registration number Immunopathological Analysis in a French National Cohort of Membranous Nephropathy (IHMN), NCT04326218. Podcast This article contains a podcast at

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J Am Soc Nephrol

Distinguishing among HCO3-, CO3=, and H+ as Substrates of Proteins That Appear To Be "Bicarbonate" Transporters.

Calibrating pHS/Im in oocytes expressing the H+ channel HV1, we find that our NBCe1 data align closely with predictions of CO3= transport (mechanism 2), while ruling out HCO3- (mechanism 1) and CO2/HCO3--stimulated H+ transport (mechanism 3). Our surface chemistry approach makes it possible for the first time to distinguish among HCO3-, CO3=, and H+ fluxes, thereby providing insight into molecular actions of clinically relevant acid-base transporters and carbonic-anhydrase inhibitors.

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Effector Memory-Expressing CD45RA (TEMRA) CD8+ T Cells from Kidney Transplant Recipients Exhibit Enhanced Purinergic P2X4 Receptor-Dependent Proinflammatory and Migratory Responses.

Our findings highlight the active role of TEMRA CD8 + T cells in humoral transplant rejection and suggest that kidney transplant recipients may benefit from therapeutics targeting these cells.

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Glucose/Fructose Delivery to the Distal Nephron Activates the Sodium-Chloride Cotransporter via the Calcium-Sensing Receptor.

In healthy volunteers, cinacalcet administration, fructose intake, or a single dose of dapagliflozin increased SPAK and NCC phosphorylation in urinary extracellular vesicles. Glycosuria or fructosuria was associated with increased NCC, SPAK, and WNK4 phosphorylation in a CaSR-dependent manner.

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Testican-2 is Associated with Reduced Risk of Incident ESKD.

Across three cohorts spanning >8,000 individuals, testican-2 is associated with kidney health and prognosis, with higher levels associated with reduced risk of ESKD.

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Translation Rescue by Targeting Ppp1r15a through Its Upstream Open Reading Frame in Sepsis-Induced Acute Kidney Injury in a Murine Model.

We found that Ppp1r15a is translationally repressed during late-phase sepsis because of the existence of an uORF, which is a prime therapeutic candidate for this strategic rescue of translation in late-phase sepsis. The ability to accurately control translation dynamics during sepsis may offer new paths for the development of therapies at codon-level precision.

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XBP1 Activation Reduces Severity of Polycystic Kidney Disease due to a Nontruncating Polycystin-1 Mutation in Mice.

Modulating ER chaperone function through XBP1 activity improved Pkd in a murine model of PC1, suggesting therapeutic targeting of hypomorphic mutations.

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Kidney Int

Antioxidant nanozymes for prevention of diseased kidney from failure.

One of the drawbacks of using natural antioxidants is their low bioavailability, which limits their anti-free radical efficacy. This commentary discusses novel antioxidant gold-platinum nanoparticles and their potential for prevention of kidney failure in patients who are diagnosed with chronic kidney disease.

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Chloride-sensitive signaling turns the potassium switch on.

A new mouse model carrying a chloride-insensitive WNK4 mutant still shows NCC activation on low potassium diet. These effects are mediated by WNK4 activation and kelch-like 3 (KLHL3) inhibition and reveal additional chloride-sensitive pathways for NCC activation.

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Endothelium and endothelin: regulators of arterial stiffness and fibrinolysis in ANCA-associated vasculitis.

Acute infusion of an endothelin ET receptor antagonist reduced vasoconstriction and arterial stiffness. This Commentary discusses biological insights and clinical implications of this study.

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Enhancer and super-enhancer landscape in polycystic kidney disease.

Finally, inhibiting glycolysis and glutaminolysis or activating Ppara in Pkd1-mutant cells lowerd global H3K27ac levels and its abundance on c-Myc enhancers. Thus, our work suggests that epigenetic rewiring mediates the transcriptomic dysregulation in PKD, and the regulatory elements can be targeted to slow cyst growth.

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Myofibroblast depletion reduces kidney cyst growth and fibrosis in autosomal dominant polycystic kidney disease.

Further examination of ADPKD myofibroblast conditioned media showed high levels of protease inhibitors including PAI1, TIMP1 and 2, NGAL and TFPI-2, and treatment with recombinant PAI1 and TIMP1 increased ADPKD cyst epithelial cell proliferation in vitro. Thus, our findings show that myofibroblasts directly promote cyst epithelial cell proliferation, cyst growth and fibrosis in ADPKD kidneys, and their targeting could be a novel therapeutic strategy to treat PKD.

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Polyploid tubular cells and chronic kidney disease.

They show that DNA damage in TEC triggers endoreplication leading to polyploid TEC and CKD. Blocking endoreplication preserved kidney function, suggesting that DNA damage triggers CKD via TEC polyploidization, questioning the concept of G2/M-arrest.

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Results from part A of the multi-center, double-blind, randomized, placebo-controlled NefIgArd trial evaluated targeted-release formulation of budesonide for the treatment of primary immunoglobulin A nephropathy.

Part B is ongoing and will be reported on later. Thus, NefIgArd is the first phase 3 IgA nephropathy trial to show clinically important improvements in UPCR and eGFR and confirms the findings from the phase 2b NEFIGAN study.

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Zoning in on podocytes.

Expanding this approach to a regional assessment demonstrates that the podocytes from cortical, subcortical, and juxtamedullary glomeruli are not only morphologically heterogeneous per se, but respond differently to stressors, such as age and hypertension. This suggests that zonal glomerular changes harbor critical information to understand glomerulopathies.

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Nephrol Dial Transplant

Extrapolated longer-term effects of the DAPA-CKD trial: a modelling analysis.

Adding dapagliflozin to standard therapeutic management of CKD is expected to have long-term cardiorenal benefit beyond what has been demonstrated in the DAPA-CKD trial, with patients predicted to live longer with fewer complications.

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Steroidal or non-steroidal MRAs: should we still enable RAASi use through K binders?

Sodium-glucose cotransporter-2 inhibitors also decrease hyperkalemia risk in patients on MRAs and decrease cardiovascular events and kidney disease progression. These may be better first-line interventions to obviate the need for potassium binders and offer additional benefits.

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TNF or EGFR inhibition equally block AKI-to-CKD transition: opportunities for etanercept treatment.

Short-term anti-TNF biologics during or after AKI could be helpful in the prevention of AKI-to-CKD transition.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Clin J Am Soc Nephrol

Integrating PROMs in Routine Dialysis Care: The Devil Is in the (Implementation) Details.

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Understanding Public Perspectives on Opt-Out Deceased Donor Transplant Policy: Ethically Obligatory and Practically Necessary.

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J Am Soc Nephrol

Sweet-Talking the Distal Nephron Calcium-Sensing Receptor.

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Kidney Int

Defining measures of kidney function in observational studies using routine healthcare data: methodological and reporting considerations.

This review illustrates the heterogeneity of working definitions of kidney disease in the scientific literature and discusses advantages and limitations of the most commonly used approaches using three examples. We summarize ways to identify and overcome possible biases and conclude by proposing a framework for reporting definitions of exposures and outcomes in studies of kidney disease using routinely collected healthcare data.

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Nat Rev Nephrol

Advances in CRISPR therapeutics.

To overcome this limitation, the toolbox of natural and engineered CRISPR-Cas systems has been dramatically expanded to include diverse tools that function in human cells for precise genome editing and epigenome engineering. The application of CRISPR technology to edit the non-coding genome, modulate gene regulation, make precise genetic changes and target infectious diseases has the potential to lead to curative therapies for many previously untreatable diseases.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Kidney Dis

Acute Kidney Injury in a Patient With a Kidney Transplant and Posttransplant Lymphoproliferative Disorder: A Quiz.

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Clin J Am Soc Nephrol

Media Analysis of the Canadian Deemed Consent Policy: Valuable Insights?

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J Am Soc Nephrol

Basic Requirements for Improving Home Dialysis Utilization: Specialty Nephrology Care and Pre-End Stage Kidney Disease Education.

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Kidney Int

Glomerulocystic kidney disease.

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The Case | An 80-year-old man with obstructive uropathy.

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The Case | Is this hemolytic uremic syndrome?

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Tumor-induced osteomalacia.

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Nat Rev Nephrol

Spatial metabolic tracing in the kidney - the future is now.

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Letters&Replies

Letters to the editors and authors’ replies

Kidney Int

Infection indication and severity.

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letter to the editor.

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Pregnancy after kidney transplantation: more attention is needed for long-term follow-up of the offspring.

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